Protocolo de actuación en el triaje del lactante / Protocol in the triage of infant

INTRODUCCIÓN. El sistema de triaje del lactante se utiliza en las unidades de Urgencias para poder establecer por medio de un protocolo, las situaciones realmente vitales y clasificar al lactante con un nivel de prioridad determinado. El triaje de este tipo de pacientes resulta complejo por las propias características del mismo y es necesario establecer un protocolo claro para la atención de este tipo de pacientes. OBJETIVO. El objetivo de este estudio es definir e identificar y mejorar las actuaciones enfermeras en el área de triaje con este tipo de pacientes con el fin de potenciar una mejora en la seguridad del paciente y optimización del servicio de Urgencias. CONCLUSIONES. Se identifica claramente por la mayoría de los autores y expertos la importancia de la formación por parte de enfermería, la experiencia de los profesionales en las unidades de Urgencias Pediátricas y la implementación de servicios que complementen la atención al paciente lactante (AU)

INTRODUCTION. Infant triage system is used in emergency units to establish by means of a protocol, the really vital situations and classify the infant with a certain level of priority. Triage of these patients is complex due to the characteristics of the same and it is necessary to establish a clear protocol for the care of these patients. OBJECTIVE. This study's objective is to define, identify and improve nursery performance on triage's area with this kind of patients with the aim to develope an improvement on patient's welfare and the optimisation of the emergencies service. CONCLUSIONS. It is clearly identified by most authors and experts the importance of nursing training from the experience of professionals in pediatric emergency units and implementation of services that complement the infant patient care (AU)

[CONSEQUENCES OF FALLS IN A GERIATRIC NURSING CENTER FOR VALID. DESCRIPTIVE STUDY]. / Consecuencias de las caídas en un centro geriátrico para ancianos válidos. ESTUDIO DESCRIPTIVO.

OBJECTIVE: To address the immediate consequences produced in the falls suffered by valid institutionalized elderly population' in the last twelve months. METHOD: A cross sectional study, by personal interview. Simple random sampling was performed. The study area corresponded to a private nursing home. The measuring instruments used in the study were the Mini Mental State Examination Lobo (MEC-35, 1979) to initially assess the level of cognitive development elderly study participants, and the WHO questionnaire for the study of falls in the elder 1989. RESULTS: Of the 21 drops produced in the last twelve months was found that 61.9% of falls were female, compared to 38.1% who relapsed in males. 52.4% of falls are not caused any consequences. 28.6% of falls caused superficial injuries and/or bruises, while the proportion of fractures corresponded to 19% for both sexes. Most of the falls did not produce immediate consequences whose percentage was 52.4% of cases. Second are superficial wounds and/or bruises with 28.6% and finally fractures with a ratio of 19%. CONCLUSIONS: The investigators considered the necessity of involvement of health professionals and the implementation ofpreventive strategies that can reduce the prevalence of falls. Thiswill successfully improve the quality of life of the elderly.

Consecuencias de las caídas en un centro geriátrico para ancianos válidos. Estudio descriptivo / Consequences of falls in a geriatric nursing center for valid. Descriptive study

Objetivo. Conocer las consecuencias inmediatas producidas en las caídas que sufre la población anciana válida institucionalizada en los últimos doce meses. Método. Estudio descriptivo trasversal, mediante entrevista personal. Se realizó un muestreo aleatorio simple. El ámbito de estudio correspondió a un centro geriátrico privado. Los instrumentos de medida utilizados en el estudio fueron el Mini Examen Cognoscitivo de Lobo (MEC-35, 1979) para valorar inicialmente el nivel cognitivo de los ancianos participantes en el estudio, y el cuestionario de la OMS para el estudio de caídas en el anciano 1989. Resultados. De las 21 caídas producidas en los últimos doce meses se comprobó que el 61.9 % de ellas correspondieron al sexo femenino, frente al 38.1 %, que recayeron en el sexo masculino. En el 52.4 % de los casos, las caídas no ocasionaron ninguna consecuencia. El 28.6 % de las caídas ocasionaron heridas superficiales o contusiones, mientras que la proporción de fracturas correspondió a un 19 % para ambos sexos. La mayoría de las caídas no produjeron consecuencias inmediatas (el 52.4 % de los casos). En segundo lugar, encontramos las heridas superficiales o contusiones, con un 28.6 %, y finalmente las fracturas, con una proporción del 19 %. Conclusiones: Los investigadores del estudio consideran necesario la implicación de los profesionales sanitarios y la implementación de estrategias preventivas que logren disminuir la prevalencia de caídas. Esto permitirá mejorar satisfactoriamente la calidad de vida de nuestros mayores (AU)

Objective. To address the immediate consequences produced in the falls suffered by valid institutionalized elderly population in the last twelve months. Method. A cross sectional study, by personal interview. Simple random sampling was performed. The study area corresponded to a private nursing home. The measuring instruments used in the study were the Mini Mental State Examination Lobo (MEC- 35, 1979) to initially assess the level of cognitive development elderly study participants, and the WHO questionnaire for the study of falls in the elder 1989. Results. Of the 21 drops produced in the last twelve months was found that 61.9 % of falls were female, compared to 38.1 % who relapsed in males. 52.4 % of falls are not caused any consequences. 28.6 % of falls caused superficial injuries and/or bruises, while the proportion of fractures corresponded to 19 % for both sexes. Most of the falls did not produce immediate consequences whose percentage was 52.4 % of cases. Second are superficial wounds and/or bruises with 28.6 % and finally fractures with a ratio of 19 %. Conclusions. The investigators considered the necessity of involvement of health professionals and the implementation of preventive strategies that can reduce the prevalence of falls. This will successfully improve the quality of life of the elderly (AU)

[Protocol in the Triage of Infant]. / Protocolo de actuación en el triaje del lactante.

Introduction: Infant triage system is used in emergency units to establish by means of a protocol, the really vital situations and classify the infant with a certain level of priority. Triage of these patients is complex due to the characteristics of the same and it is necessary to establish a clear protocol for the care of these patients. Objective: This study's objective is to define, identify and improve nursery performance on triage's area with this kind of patients with the aim to develope an improvement on patient's welfare and optimization of the emergency service. Conclusions: It is clearly identified by most authors and experts the importance of nursing training from the experience of professionals in pediatric emergency units and implementation of services that complement the infant patient care.

Actuación de enfermería ante el cuidado físico en el paciente terminal / Nursing action before the terminal patient physical care

Los cuidados paliativos son acciones ejercidas por los profesionales de enfermería para aumentar el confort y bienestar en pacientes con enfermedad terminal. La OMS define estos cuidados como «El enfoque que mejora la calidad de vida de los pacientes y familias que se enfrentan a los problemas asociados con enfermedades amenazantes para la vida, a través de la prevención y alivio del sufrimiento por medio de la identificación temprana e impecable evaluación y tratamiento del dolor y otros problemas físicos, psicológicos y espirituales» [1]. La precursora de los cuidados paliativos fue Cicely Mary Strode Saunders, quien explica la necesidad de modificar las Unidades de Cuidados Paliativos para mejorar la calidad de vida de los pacientes irreversibles. Los cuidados paliativos son necesarios en pacientes que presentan una enfermedad en situación terminal. El pronóstico de vida en este tipo de situaciones es inferior a seis meses. Se considera al ser humano un modelo biopsicosocial. Es por esta razón que el profesional de enfermería debe atender a todas las necesidades derivadas de estas tres dimensiones de la persona. En este artículo abordaremos los cuidados paliativos en el paciente terminal, teniendo en cuenta la faceta el profesional de enfermería como referente en la enseñanza de los cuidados al cuidador principal (AU)

Palliative care is a group of actions performed by nurses in order to increase the comfort and well-being of patients with terminal illnesses. The World Health Organization (WHO) defines this term as: «An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual [1]. Cicely Mary Strode Saunders is considered as the precursor of the palliative care, who explained the need to change the Palliative Care Units in order to improve the quality of life of patients with terminal illnesses. Palliative care is necessary for patients with a terminal illness. In such cases, the life expectancy is less than six months. Human being is considered a biopsychosocial model. For this reason, the nurse must take into account all the requirements arising from these three dimensions of the human being. In this essay, we deal with palliative care in patients with terminal illnesses, considering the role of the nurse as an important reference when teaching palliative care to the main carer (AU)

[NURSING ACTION BEFORE THE TERMINAL PATIENT PHYSICAL CARE]. / Actuación de enfermería ante e culdado físico en el paciente terminal.

Palliative care is a group of actions performed by nurses in order to increase the comfort and well-being of patients with terminal illnesses. The World Health Organization (WHO) defines this term as: An approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual [1]. Cicely Mary Strode Saunders is considered as the precursor of the palliative care, who explained the need to change the Palliative Care Units in order to improve the quality of life of patients with terminal illnesses. Palliative care is necessary for patients with a terminal illness. In such cases, the life expectancy is less than six months. Human being is considered a biopsychosocial model. For this reason, the nurse must take into account all the requirements arising from these three dimensions of the human being. In this essay, we deal with palliative care in patients with terminal illnesses, considering the role of the nurse as an important reference when teaching palliative care to the main carer.

[The most frequent digestive disorders in the elderly]. / Los trastornos digestivos más frecuentes en las personas ancianas.

Aging is a stage with various changes and physiological modifications. It's a progressive, dynamic and irreversible process. Elderly people are beings fragile, multipathological, and polimedicated. 40 Of the world's population has indigestion. They are the most common digestive disorders: constipation, dysphagia, and dyspepsia, reaching levels of prevalence around the 25, 30 and 25 respectively. The main activity of the nursing professional lies in making a proper assessment of the patient and offer a health education regarding habits hygiene and dietetics, in order to reduce the intake of drugs and increase the quality of life of our elders. We should not forget that the family plays a fundamental role for the treatment of these disorders.

Los trastornos digestivos más frecuentes en las personas ancianas / The most frequent digestive disorders in the elderly

El envejecimiento constituye una etapa con diversos cambios y modificaciones fisiológicas. Se trata de un proceso progresivo, dinámico e irreversible. Las personas ancianas son seres frágiles, pluripatológicos, y polimedicados. El 40% de la población mundial presenta indigestión. Los trastornos digestivos más frecuentes son: el estreñimiento, la disfagia y la dispepsia, alcanzando cotas de prevalencia en torno al 25%, 30% y 25% respectivamente. La actividad principal del profesional de enfermería radica en realizar una adecuada valoración del paciente, y ofrecer una educación sanitaria en relación a hábitos higiénico-dietéticos, con el fin de reducir la ingesta de fármacos y aumentar la calidad de vida de nuestros ancianos. No debemos de olvidar que el entorno familiar juega un rol fundamental para el tratamiento de estos trastornos(AU)

After a diet and hydric restriction, travelling is one of the most limiting and worrying activities for patients under chronic renal replacement therapy. The vital dependency on the hemodialysis machine makes travelling an extremely difficult experience. In order to prove the legitimacy of our patients’ fears, we embarked on to a cruise-liner with them. This confirmed their limitations when travelling thanks to the reliable data input. This study describes our personal and professional experience as nurses, specialized in hemodialysis, embarking onto a cruise-liner with twelve patients suffering from ESRD. Our goal is to share that experience with professional nurses as well as patients who seek information in regards to this type of trip with a specialized nurse. A summary of this work was presented as a communication oral in the XXXVI Congress of the SpanishSociety of Nephrology Nursing (AU)

[Prevalence and profile of the elderly home care valid suffering in a private residence falls]. / Caídas en ancianos válidos institucionalizados: prevalencia y perfil.

OBJECTIVE: To estimate the prevalence of falls in people over 65 years old institutionalized and to know the elderly profile of those who suffered falls in the last 12 months. METHOD: It was performed a transversal-descriptive study. The instruments used were the Mini-Mental State Examination (MMSE-35 Lobo, 1979) and the Questionnaire (1989) for the study of falls in the elderly. It was collected the following variables: age, sex, BMI, weight, height, assistive devices for ambulation, fear of falling, falling place, difficulty in actions, sort of footwear, fall time, lighting at the fall time, objects that could favour the fall, type of fall and contact with the health system. RESULTS: All of the participants in this study were 51 valid elderly and institutionalized. In the last 12 months, 21 individuals suffered a fall. This is equivalent to 41,17% in both sexes, being a 61,91% for women and 38,09% for men. The BMI average in all of the study participants amounts to 26,6 kg/m2. By the MCA, it was observed how the overweight variable is, without any doubt, linked with suffering a fall. In the Mantel-Haenszel test, it was obtained that women between 85-90 years old had a 42% more probability of falling. The places with the highest prevalence of falls were inside the nursing home with 71,4%. The women reported a fear sensation in order to suffer a second fall by 84,6% and the men by 75% over the total falls which were produced in both sexes. From the elderly who suffered falls, 52,38% used technical assistance to ambulate, compared to the 47,61% who didn't use. The footwear, which was used the most at the time of the fall, was slippers with 38,1%. Most falls took place in the morning with a percentage of 47,6% and the 90,5% of the falls occurred with an optimal lighting and in the 71,4% of the falls, there wasn't anything that favoured them. The 66,7% of the falls didn't need health care after them and the 52,4% of the falls had no physical consequences. The main difficulties that arise in our elderly are run and roam. CONCLUSIONS: The record of the falls has allowed to know the falls prevalence which corresponds to 41,17% in both sexes. It's usually a woman aged between 85 and 90 years old with a MMSE-35 of 31,4 points and a BMI of 26,6 kg/m2 on average. The falls occur inside the nursing home and showed a high fear of faIling. The footwear used was slippers without technical assistance to ambulate. Most of the falls took place in the morning with optimal lighting conditions and without any object that had favoured the fall. The majority of the falls didn't present immediate consequences after them and they didn't seek healthcare. Therefore, it can be assumed that the falls could be influenced by intrinsic factors, maybe the elderly comorbidity could influence. It's clear that the furniture of the institution is not a decisive factor, although the highest prevalence appears inside the nursing home, but it was found that the elderly spend most of their time inside the nursing home. We're facing a public health problem, for our country's health system doesn't have an accurate estimate referring to the falls prevalence in the elderly population.